Antenatal care Flashcards
Trimesters
first: <12 weeks
second: 13-26
third >27-birth
booking visit weeks
8-12 weeks
booking visit features
general information: diet, alcohol, smoking, folic acid, vitD, antenatal classes
BP, urine dipstick, check BMI
booking bloods/ urine
FBC, blood group, rhesus status, red cell alloantibodies, haemoglobinopathies(thalassaemia and sickel cells)
hepB, syphilis
HIV
urine culture
dating scan weeks
10-13+6
dating scan features:
CRL,multiple pregnancies identified
down syndrome testing
eeks
11-13+6 weeks
antenatal appointment weeks
16 weeks
anomaly scan weeks
18-20+6 weeks
USS
OGTT date
24-28weeks
anti-D injections date
28 and 34 weeks
when is symphysis-fundal height measured
> 24 weeks
vaccines in pregnant women
whooping cough 16 weeks
annual flu
folic acid in pregnancy
Take folic acid 400mcg from before pregnancy to 12 weeks (reduces neural tube defects)
effects of alcohol in pregnancy
Miscarriage
Small for dates
Preterm delivery
Fetal alcohol syndrome
features of fetal alcohol
Microcephaly (small head)
Thin upper lip
Smooth flat philtrum (the groove between the nose and upper lip)
Short palpebral fissure (short horizontal distance from one side of the eye to the other)
Learning disability
Behavioural difficulties
Hearing and vision problems
Cerebral palsy
smoking in pregnancy effects
Fetal growth restriction (FGR)
Miscarriage
Stillbirth
Preterm labour and delivery
Placental abruption
Pre-eclampsia
Cleft lip or palate
Sudden infant death syndrome (SIDS)
flying in pregnancy
The RCOG advises flying is generally ok in uncomplicated healthy pregnancies up to:
37 weeks in a single pregnancy
32 weeks in a twin pregnancy
risk factors for gestational diabetes
BMI above 30
Previous baby >4.5kg
Previous gestational diabetes
FH of diabetes
Family origin with a high prevalence of diabetes
risk factors for pre-eclampsia
BP & urinalysis for protein
> 40
Nulliparity
Pregnancy interval >20 years
FH
BMI >30
Renal or vascular disease
Multiple pregnancy
what conditions are women screened for?
rhesus negative gestational diabetes fetal growth restriction venous thromboembolism pre-eclampsia
combined test down syndrome
Nuchal length
PAPP-A
bHCG
11-13+6
quadruple test down syndrome
15-20 weeks inhibin A UE3 (oestriol) HCG aFP
25 weeks
Routine care: BP, urine dipstick, symphysis-fundal height (SFH)
28 weeks
Routine care: BP, urine dipstick, SFH
Second screen for anaemia and atypical red cell alloantibodies. If Hb < 10.5 g/dl consider iron
First dose of anti-D prophylaxis to rhesus negative women
31 weeks
If primip
routine care
34 weeks
Routine care as above
Second dose of anti-D prophylaxis to rhesus negative women*
Information on labour and birth plan
36 weeks
Routine care as above
Check presentation - offer external cephalic version if indicated
Information on breast feeding, vitamin K, ‘baby-blues’
38 weeks
routine care as above
40 weeks
routine care
only if primip
Discussion about options for prolonged pregnancy
41 weeks
Routine care as above
Discuss labour plans and possibility of induction
triple test down syndrome
14-20 weeks
BHCG
AFP
serum oestriol
chorionic villus sampling
US-guided biopsy of placental tissue
testing is done earlier in pregnancy
before 15 weeks
amniocentesis
US-guided aspiration of amniotic fluid
after 15 weeks
